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Is OCD an addiction like drugs or gambling?

In a test designed to measure decision-making, individuals with OCD performed much like gambling addicts, suggesting their underlying brain problems may be similar.

OCD makes people worry obsessively, compelling them to carry out rituals like repeated hand washing. It affects about one in 50 people and can take over their lives. Because sufferers get anxious if they can’t complete their rituals, OCD is usually treated as an anxiety disorder with talking therapies to relieve distress or anti-anxiety drugs. These approaches reduce symptoms but only a minority of people are cured.

In the new study, 80 people – half of whom had OCD – had to choose cards from four decks, winning or losing money in the process. Two decks were rigged to produce big wins but even bigger losses. The people without OCD learned to choose from the two safer decks but those with the disorder were consistently less likely to make good judgements and finished with a significantly lower final score.

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Drug and gambling addicts also perform poorly on the test. That doesn’t prove OCD is an addiction but a growing body of work, including brain scans and other cognitive tests, suggest it should be recast in this way, says Naomi Fineberg of the University of Hertfordshire in Welwyn Garden City. Both addiction and OCD “share a lack of control of behaviour”, she says.

Cognitive tests and brain scans suggest addiction and OCD share a lack of control of behaviour

People with OCD might benefit from talking therapies and drugs designed for addictions, says Giacomo Grassi at the University of Florence in Italy, who recently presented the work at the European Congress of Psychiatry in Munich, Germany. For example, a compound called N-acetylcysteine, which looks promising as a treatment for drug and gambling addiction, also seems to help in OCD.

This article appeared in print under the headline “OCD makes people behave like gamblers”